Locking casters for surgical systems

ABSTRACT

A caster assembly includes a caster and a lock member. The caster can include a caster support coupled to the robotic surgery console and a caster wheel rotatably coupled to the caster support. The lock member can include a pivot component, an extension portion, and a brake portion. The brake portion can pivot relative to the caster between a locked position and an unlocked position. In the locked position, the brake portion engages with the caster wheel, and in the unlocked position, the brake portion is disengaged with the caster wheel.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.63/350,003 filed Jun. 7, 2022 and entitled, “Locking Casters forSurgical Systems”, which is incorporated by reference herein as ifreproduced in its entirety.

TECHNICAL FIELD

Systems and methods disclosed herein related to surgical systems, andmore particularly to systems to transport surgical systems.

BACKGROUND

Minimally invasive procedures allow for access to a targeted site withina patient with minimal trauma to the patient. For example, laparoscopicsurgery can allow for surgical access to a patient's cavity through asmall incision on the patient's abdomen. A cannula can form a surgicalcorridor to allow tools to access the patient's cavity. In someprocedures, the cannula can be coupled to a robotic arm to allow therobotic arm to rotate, pivot, or otherwise move the cannula within thepatient's cavity. By moving the cannula within the patient's cavity,tools operatively coupled to the robotic arm can access desired portionsof the patient's cavity. In some applications, the cannula can beattached and/or detached from the robotic arm to facilitate positioning,configuration, and/or sterilization of the cannula.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed aspects will hereinafter be described in conjunction withthe appended drawings, provided to illustrate and not to limit thedisclosed aspects, wherein like designations denote like elements.

FIG. 1 illustrates an embodiment of a cart-based robotic system arrangedfor diagnostic and/or therapeutic bronchoscopy procedure(s).

FIG. 2 depicts further aspects of the robotic system of FIG. 1 .

FIG. 3 illustrates an embodiment of the robotic system of FIG. 1arranged for ureteroscopy.

FIG. 4 illustrates an embodiment of the robotic system of FIG. 1arranged for a vascular procedure.

FIG. 5 illustrates an embodiment of a table-based robotic systemarranged for a bronchoscopy procedure.

FIG. 6 provides an alternative view of the robotic system of FIG. 5 .

FIG. 7 illustrates an example system configured to stow robotic arm(s).

FIG. 8 illustrates an embodiment of a table-based robotic systemconfigured for a ureteroscopy procedure.

FIG. 9 illustrates an embodiment of a table-based robotic systemconfigured for a laparoscopic procedure.

FIG. 10 illustrates an embodiment of the table-based robotic system ofFIGS. 5-9 with pitch or tilt adjustment.

FIG. 11 provides a detailed illustration of the interface between thetable and the column of the table-based robotic system of FIGS. 5-10 .

FIG. 12 illustrates an alternative embodiment of a table-based roboticsystem.

FIG. 13 illustrates an end view of the table-based robotic system ofFIG. 12 .

FIG. 14 illustrates an end view of a table-based robotic system withrobotic arms attached thereto.

FIG. 15 illustrates an exemplary instrument driver.

FIG. 16 illustrates an exemplary medical instrument with a pairedinstrument driver.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument.

FIG. 18 illustrates an instrument having an instrument-based insertionarchitecture.

FIG. 19 illustrates an exemplary controller.

FIG. 20 depicts a block diagram illustrating a localization system thatestimates a location of one or more elements of the robotic systems ofFIGS. 1-10 , such as the location of the instrument of FIGS. 16-18 , inaccordance to an example embodiment.

FIG. 21 illustrates a perspective view of a console.

FIG. 22 illustrates a perspective view of a caster assembly.

FIG. 23 illustrates a partial elevation view of the caster assembly ofFIG. 22 with the lock members in an unlocked position.

FIG. 24 illustrates a partial elevation view of the caster assembly ofFIG. 22 with the lock members in a locked position.

FIG. 25 illustrates an exploded perspective view of a lock member.

FIG. 26 illustrates a partial perspective view of the caster assembly ofFIG. 22 .

FIG. 27 illustrates a partial exploded perspective view of the lockmembers and the pedal assembly.

FIG. 28 illustrates a perspective view of a caster assembly.

FIG. 29 illustrates a partial exploded perspective view of the pedalassemblies.

FIG. 30 illustrates a perspective view of a pedal assembly.

FIG. 31 illustrates a rear elevation view of the pedal assembly.

FIG. 32 illustrates a perspective view of a caster assembly with thedirection locking mechanism unlocked.

FIG. 33 illustrates a perspective view of a caster assembly with thedirection locking mechanism locked.

FIG. 34 illustrates a side elevation view of a direction locking pedalassembly.

FIG. 35 illustrates a partial perspective view of a direction lockingpedal assembly.

DETAILED DESCRIPTION 1. Overview

Aspects of the present disclosure may be integrated into a roboticallyenabled medical system capable of performing a variety of medicalprocedures, including both minimally invasive, such as laparoscopy, andnon-invasive, such as endoscopy, procedures. Among endoscopy procedures,the system may be capable of performing bronchoscopy, ureteroscopy,gastroscopy, etc.

In addition to performing the breadth of procedures, the system mayprovide additional benefits, such as enhanced imaging and guidance toassist the physician. Additionally, the system may provide the physicianwith the ability to perform the procedure from an ergonomic positionwithout the need for awkward arm motions and positions. Still further,the system may provide the physician with the ability to perform theprocedure with improved ease of use such that one or more of theinstruments of the system can be controlled by a single user.

Various embodiments will be described below in conjunction with thedrawings for purposes of illustration. It should be appreciated thatmany other implementations of the disclosed concepts are possible, andvarious advantages can be achieved with the disclosed implementations.Headings are included herein for reference and to aid in locatingvarious sections. These headings are not intended to limit the scope ofthe concepts described with respect thereto. Such concepts may haveapplicability throughout the entire specification.

A. Robotic System—Cart.

The robotically enabled medical system may be configured in a variety ofways depending on the particular procedure. FIG. 1 illustrates anembodiment of a cart-based robotically enabled system 10 arranged for adiagnostic and/or therapeutic bronchoscopy procedure. During abronchoscopy, the system 10 may comprise a cart 11 having one or morerobotic arms 12 to deliver a medical instrument, such as a steerableendoscope 13, which may be a procedure-specific bronchoscope forbronchoscopy, to a natural orifice access point (i.e., the mouth of thepatient positioned on a table in the present example) to deliverdiagnostic and/or therapeutic tools. As shown, the cart 11 may bepositioned proximate to the patient's upper torso in order to provideaccess to the access point. Similarly, the robotic arms 12 may beactuated to position the bronchoscope relative to the access point. Thearrangement in FIG. 1 may also be utilized when performing agastro-intestinal (GI) procedure with a gastroscope, a specializedendoscope for GI procedures. FIG. 2 depicts an example embodiment of thecart in greater detail.

With continued reference to FIG. 1 , once the cart 11 is properlypositioned, the robotic arms 12 may insert the steerable endoscope 13into the patient robotically, manually, or a combination thereof. Asshown, the steerable endoscope 13 may comprise at least two telescopingparts, such as an inner leader portion and an outer sheath portion, eachportion coupled to a separate instrument driver from the set ofinstrument drivers 28, each instrument driver coupled to the distal endof an individual robotic arm. This linear arrangement of the instrumentdrivers 28, which facilitates coaxially aligning the leader portion withthe sheath portion, creates a “virtual rail” 29 that may be repositionedin space by manipulating the one or more robotic arms 12 into differentangles and/or positions. The virtual rails described herein are depictedin the Figures using dashed lines, and accordingly the dashed lines donot depict any physical structure of the system. Translation of theinstrument drivers 28 along the virtual rail 29 telescopes the innerleader portion relative to the outer sheath portion or advances orretracts the endoscope 13 from the patient. The angle of the virtualrail 29 may be adjusted, translated, and pivoted based on clinicalapplication or physician preference. For example, in bronchoscopy, theangle and position of the virtual rail 29 as shown represents acompromise between providing physician access to the endoscope 13 whileminimizing friction that results from bending the endoscope 13 into thepatient's mouth.

The endoscope 13 may be directed down the patient's trachea and lungsafter insertion using precise commands from the robotic system untilreaching the target destination or operative site. In order to enhancenavigation through the patient's lung network and/or reach the desiredtarget, the endoscope 13 may be manipulated to telescopically extend theinner leader portion from the outer sheath portion to obtain enhancedarticulation and greater bend radius. The use of separate instrumentdrivers 28 also allows the leader portion and sheath portion to bedriven independent of each other.

For example, the endoscope 13 may be directed to deliver a biopsy needleto a target, such as, for example, a lesion or nodule within the lungsof a patient. The needle may be deployed down a working channel thatruns the length of the endoscope to obtain a tissue sample to beanalyzed by a pathologist. Depending on the pathology results,additional tools may be deployed down the working channel of theendoscope for additional biopsies. After identifying a nodule to bemalignant, the endoscope 13 may endoscopically deliver tools to resectthe potentially cancerous tissue. In some instances, diagnostic andtherapeutic treatments can be delivered in separate procedures. In thosecircumstances, the endoscope 13 may also be used to deliver a fiducialto “mark” the location of the target nodule as well. In other instances,diagnostic and therapeutic treatments may be delivered during the sameprocedure.

The system 10 may also include a movable tower 30, which may beconnected via support cables to the cart 11 to provide support forcontrols, electronics, fluidics, optics, sensors, and/or power to thecart 11. Placing such functionality in the tower 30 allows for a smallerform factor cart 11 that may be more easily adjusted and/orre-positioned by an operating physician and his/her staff. Additionally,the division of functionality between the cart/table and the supporttower 30 reduces operating room clutter and facilitates improvingclinical workflow. While the cart 11 may be positioned close to thepatient, the tower 30 may be stowed in a remote location to stay out ofthe way during a procedure.

In support of the robotic systems described above, the tower 30 mayinclude component(s) of a computer-based control system that storescomputer program instructions, for example, within a non-transitorycomputer-readable storage medium such as a persistent magnetic storagedrive, solid state drive, etc. The execution of those instructions,whether the execution occurs in the tower 30 or the cart 11, may controlthe entire system or sub-system(s) thereof. For example, when executedby a processor of the computer system, the instructions may cause thecomponents of the robotics system to actuate the relevant carriages andarm mounts, actuate the robotics arms, and control the medicalinstruments. For example, in response to receiving the control signal,the motors in the joints of the robotics arms may position the arms intoa certain posture.

The tower 30 may also include a pump, flow meter, valve control, and/orfluid access in order to provide controlled irrigation and aspirationcapabilities to the system that may be deployed through the endoscope13. These components may also be controlled using the computer system oftower 30. In some embodiments, irrigation and aspiration capabilitiesmay be delivered directly to the endoscope 13 through separate cable(s).

The tower 30 may include a voltage and surge protector designed toprovide filtered and protected electrical power to the cart 11, therebyavoiding placement of a power transformer and other auxiliary powercomponents in the cart 11, resulting in a smaller, more moveable cart11.

The tower 30 may also include support equipment for the sensors deployedthroughout the robotic system 10. For example, the tower 30 may includeopto-electronics equipment for detecting, receiving, and processing datareceived from the optical sensors or cameras throughout the roboticsystem 10. In combination with the control system, such opto-electronicsequipment may be used to generate real-time images for display in anynumber of consoles deployed throughout the system, including in thetower 30. Similarly, the tower 30 may also include an electronicsubsystem for receiving and processing signals received from deployedelectromagnetic (EM) sensors. The tower 30 may also be used to house andposition an EM field generator for detection by EM sensors in or on themedical instrument.

The tower 30 may also include a console 31 in addition to other consolesavailable in the rest of the system, e.g., console mounted on top of thecart. The console 31 may include a user interface and a display screen,such as a touchscreen, for the physician operator. Consoles in system 10are generally designed to provide both robotic controls as well aspre-operative and real-time information of the procedure, such asnavigational and localization information of the endoscope 13. When theconsole 31 is not the only console available to the physician, it may beused by a second operator, such as a nurse, to monitor the health orvitals of the patient and the operation of system, as well as provideprocedure-specific data, such as navigational and localizationinformation. In other embodiments, the console 30 is housed in a bodythat is separate from the tower 30.

The tower 30 may be coupled to the cart 11 and endoscope 13 through oneor more cables or connections (not shown). In some embodiments, thesupport functionality from the tower 30 may be provided through a singlecable to the cart 11, simplifying and de-cluttering the operating room.In other embodiments, specific functionality may be coupled in separatecabling and connections. For example, while power may be providedthrough a single power cable to the cart, the support for controls,optics, fluidics, and/or navigation may be provided through a separatecable.

FIG. 2 provides a detailed illustration of an embodiment of the cartfrom the cart-based robotically enabled system shown in FIG. 1 . Thecart 11 generally includes an elongated support structure 14 (oftenreferred to as a “column”), a cart base 15, and a console 16 at the topof the column 14. The column 14 may include one or more carriages, suchas a carriage 17 (alternatively “arm support”) for supporting thedeployment of one or more robotic arms 12 (three shown in FIG. 2 ). Thecarriage 17 may include individually configurable arm mounts that rotatealong a perpendicular axis to adjust the base of the robotic arms 12 forbetter positioning relative to the patient. The carriage 17 alsoincludes a carriage interface 19 that allows the carriage 17 tovertically translate along the column 14.

The carriage interface 19 is connected to the column 14 through slots,such as slot 20, that are positioned on opposite sides of the column 14to guide the vertical translation of the carriage 17. The slot 20contains a vertical translation interface to position and hold thecarriage at various vertical heights relative to the cart base 15.Vertical translation of the carriage 17 allows the cart 11 to adjust thereach of the robotic arms 12 to meet a variety of table heights, patientsizes, and physician preferences. Similarly, the individuallyconfigurable arm mounts on the carriage 17 allow the robotic arm base 21of robotic arms 12 to be angled in a variety of configurations.

In some embodiments, the slot 20 may be supplemented with slot coversthat are flush and parallel to the slot surface to prevent dirt andfluid ingress into the internal chambers of the column 14 and thevertical translation interface as the carriage 17 vertically translates.The slot covers may be deployed through pairs of spring spoolspositioned near the vertical top and bottom of the slot 20. The coversare coiled within the spools until deployed to extend and retract fromtheir coiled state as the carriage 17 vertically translates up and down.The spring-loading of the spools provides force to retract the coverinto a spool when carriage 17 translates towards the spool, while alsomaintaining a tight seal when the carriage 17 translates away from thespool. The covers may be connected to the carriage 17 using, forexample, brackets in the carriage interface 19 to ensure properextension and retraction of the cover as the carriage 17 translates.

The column 14 may internally comprise mechanisms, such as gears andmotors, that are designed to use a vertically aligned lead screw totranslate the carriage 17 in a mechanized fashion in response to controlsignals generated in response to user inputs, e.g., inputs from theconsole 16.

The robotic arms 12 may generally comprise robotic arm bases 21 and endeffectors 22, separated by a series of linkages 23 that are connected bya series of joints 24, each joint comprising an independent actuator,each actuator comprising an independently controllable motor. Eachindependently controllable joint represents an independent degree offreedom available to the robotic arm. Each of the arms 12 have sevenjoints, and thus provide seven degrees of freedom. A multitude of jointsresult in a multitude of degrees of freedom, allowing for “redundant”degrees of freedom. Redundant degrees of freedom allow the robotic arms12 to position their respective end effectors 22 at a specific position,orientation, and trajectory in space using different linkage positionsand joint angles. This allows for the system to position and direct amedical instrument from a desired point in space while allowing thephysician to move the arm joints into a clinically advantageous positionaway from the patient to create greater access, while avoiding armcollisions.

The cart base 15 balances the weight of the column 14, carriage 17, andarms 12 over the floor. Accordingly, the cart base 15 houses heaviercomponents, such as electronics, motors, power supply, as well ascomponents that either enable movement and/or immobilize the cart. Forexample, the cart base 15 includes rollable wheel-shaped casters 25 thatallow for the cart to easily move around the room prior to a procedure.After reaching the appropriate position, the casters may be immobilizedusing wheel locks to hold the cart 11 in place during the procedure.

Positioned at the vertical end of column 14, the console 16 allows forboth a user interface for receiving user input and a display screen (ora dual-purpose device such as, for example, a touchscreen 26) to providethe physician user with both pre-operative and intra-operative data.Potential pre-operative data on the touchscreen 26 may includepre-operative plans, navigation and mapping data derived frompre-operative computerized tomography (CT) scans, and/or notes frompre-operative patient interviews. Intra-operative data on display mayinclude optical information provided from the tool, sensor andcoordinate information from sensors, as well as vital patientstatistics, such as respiration, heart rate, and/or pulse. The console16 may be positioned and tilted to allow a physician to access theconsole from the side of the column 14 opposite carriage 17. From thisposition, the physician may view the console 16, robotic arms 12, andpatient while operating the console 16 from behind the cart 11. Asshown, the console 16 also includes a handle 27 to assist withmaneuvering and stabilizing cart 11.

FIG. 3 illustrates an embodiment of a robotically enabled system 10arranged for ureteroscopy. In a ureteroscopic procedure, the cart 11 maybe positioned to deliver a ureteroscope 32, a procedure-specificendoscope designed to traverse a patient's urethra and ureter, to thelower abdominal area of the patient. In a ureteroscopy, it may bedesirable for the ureteroscope 32 to be directly aligned with thepatient's urethra to reduce friction and forces on the sensitive anatomyin the area. As shown, the cart 11 may be aligned at the foot of thetable to allow the robotic arms 12 to position the ureteroscope 32 fordirect linear access to the patient's urethra. From the foot of thetable, the robotic arms 12 may insert the ureteroscope 32 along thevirtual rail 33 directly into the patient's lower abdomen through theurethra.

After insertion into the urethra, using similar control techniques as inbronchoscopy, the ureteroscope 32 may be navigated into the bladder,ureters, and/or kidneys for diagnostic and/or therapeutic applications.For example, the ureteroscope 32 may be directed into the ureter andkidneys to break up kidney stone build up using a laser or ultrasoniclithotripsy device deployed down the working channel of the ureteroscope32. After lithotripsy is complete, the resulting stone fragments may beremoved using baskets deployed down the ureteroscope 32.

FIG. 4 illustrates an embodiment of a robotically enabled systemsimilarly arranged for a vascular procedure. In a vascular procedure,the system 10 may be configured such that the cart 11 may deliver amedical instrument 34, such as a steerable catheter, to an access pointin the femoral artery in the patient's leg. The femoral artery presentsboth a larger diameter for navigation as well as a relatively lesscircuitous and tortuous path to the patient's heart, which simplifiesnavigation. As in a ureteroscopic procedure, the cart 11 may bepositioned towards the patient's legs and lower abdomen to allow therobotic arms 12 to provide a virtual rail 35 with direct linear accessto the femoral artery access point in the patient's thigh/hip region.After insertion into the artery, the medical instrument 34 may bedirected and inserted by translating the instrument drivers 28.Alternatively, the cart may be positioned around the patient's upperabdomen in order to reach alternative vascular access points, such as,for example, the carotid and brachial arteries near the shoulder andwrist.

B. Robotic System—Table.

Embodiments of the robotically enabled medical system may alsoincorporate the patient's table. Incorporation of the table reduces theamount of capital equipment within the operating room by removing thecart, which allows greater access to the patient. FIG. 5 illustrates anembodiment of such a robotically enabled system arranged for abronchoscopy procedure. System 36 includes a support structure or column37 for supporting platform 38 (shown as a “table” or “bed”) over thefloor. Much like in the cart-based systems, the end effectors of therobotic arms 39 of the system 36 comprise instrument drivers 42 that aredesigned to manipulate an elongated medical instrument, such as abronchoscope 40 in FIG. 5 , through or along a virtual rail 41 formedfrom the linear alignment of the instrument drivers 42. In practice, aC-arm for providing fluoroscopic imaging may be positioned over thepatient's upper abdominal area by placing the emitter and detectoraround table 38.

FIG. 6 provides an alternative view of the system 36 without the patientand medical instrument for discussion purposes. As shown, the column 37may include one or more carriages 43 shown as ring-shaped in the system36, from which the one or more robotic arms 39 may be based. Thecarriages 43 may translate along a vertical column interface 44 thatruns the length of the column 37 to provide different vantage pointsfrom which the robotic arms 39 may be positioned to reach the patient.The carriage(s) 43 may rotate around the column 37 using a mechanicalmotor positioned within the column 37 to allow the robotic arms 39 tohave access to multiples sides of the table 38, such as, for example,both sides of the patient. In embodiments with multiple carriages, thecarriages may be individually positioned on the column and may translateand/or rotate independent of the other carriages. While carriages 43need not surround the column 37 or even be circular, the ring-shape asshown facilitates rotation of the carriages 43 around the column 37while maintaining structural balance. Rotation and translation of thecarriages 43 allows the system to align the medical instruments, such asendoscopes and laparoscopes, into different access points on thepatient. In other embodiments (not shown), the system 36 can include apatient table or bed with adjustable arm supports in the form of bars orrails extending alongside it. One or more robotic arms 39 (e.g., via ashoulder with an elbow joint) can be attached to the adjustable armsupports, which can be vertically adjusted. By providing verticaladjustment, the robotic arms 39 are advantageously capable of beingstowed compactly beneath the patient table or bed, and subsequentlyraised during a procedure.

The arms 39 may be mounted on the carriages through a set of arm mounts45 comprising a series of joints that may individually rotate and/ortelescopically extend to provide additional configurability to therobotic arms 39. Additionally, the arm mounts 45 may be positioned onthe carriages 43 such that, when the carriages 43 are appropriatelyrotated, the arm mounts 45 may be positioned on either the same side oftable 38 (as shown in FIG. 6 ), on opposite sides of table 38 (as shownin FIG. 9 ), or on adjacent sides of the table 38 (not shown).

The column 37 structurally provides support for the table 38, and a pathfor vertical translation of the carriages. Internally, the column 37 maybe equipped with lead screws for guiding vertical translation of thecarriages, and motors to mechanize the translation of said carriagesbased the lead screws. The column 37 may also convey power and controlsignals to the carriage 43 and robotic arms 39 mounted thereon.

The table base 46 serves a similar function as the cart base 15 in cart11 shown in FIG. 2 , housing heavier components to balance the table/bed38, the column 37, the carriages 43, and the robotic arms 39. The tablebase 46 may also incorporate rigid casters to provide stability duringprocedures. Deployed from the bottom of the table base 46, the castersmay extend in opposite directions on both sides of the base 46 andretract when the system 36 needs to be moved.

Continuing with FIG. 6 , the system 36 may also include a tower (notshown) that divides the functionality of system 36 between table andtower to reduce the form factor and bulk of the table. As in earlierdisclosed embodiments, the tower may provide a variety of supportfunctionalities to table, such as processing, computing, and controlcapabilities, power, fluidics, and/or optical and sensor processing. Thetower may also be movable to be positioned away from the patient toimprove physician access and de-clutter the operating room.Additionally, placing components in the tower allows for more storagespace in the table base for potential stowage of the robotic arms. Thetower may also include a master controller or console that provides botha user interface for user input, such as keyboard and/or pendant, aswell as a display screen (or touchscreen) for pre-operative andintra-operative information, such as real-time imaging, navigation, andtracking information. In some embodiments, the tower may also containholders for gas tanks to be used for insufflation.

In some embodiments, a table base may stow and store the robotic armswhen not in use. FIG. 7 illustrates a system 47 that stows robotic armsin an embodiment of the table-based system. In system 47, carriages 48may be vertically translated into base 49 to stow robotic arms armmounts 51, and the carriages 48 within the base 49. Base covers 52 maybe translated and retracted open to deploy the carriages 48, arm mounts51, and arms 50 around column 53, and closed to stow to protect themwhen not in use. The base covers 52 may be sealed with a membrane 54along the edges of its opening to prevent dirt and fluid ingress whenclosed.

FIG. 8 illustrates an embodiment of a robotically enabled table-basedsystem configured for a ureteroscopy procedure. In a ureteroscopy, thetable 38 may include a swivel portion 55 for positioning a patientoff-angle from the column 37 and table base 46. The swivel portion 55may rotate or pivot around a pivot point (e.g., located below thepatient's head) in order to position the bottom portion of the swivelportion 55 away from the column 37. For example, the pivoting of theswivel portion 55 allows a C-arm (not shown) to be positioned over thepatient's lower abdomen without competing for space with the column (notshown) below table 38. By rotating the carriage 35 (not shown) aroundthe column 37, the robotic arms 39 may directly insert a ureteroscope 56along a virtual rail 57 into the patient's groin area to reach theurethra. In a ureteroscopy, stirrups 58 may also be fixed to the swivelportion 55 of the table 38 to support the position of the patient's legsduring the procedure and allow clear access to the patient's groin area.

In a laparoscopic procedure, through small incision(s) in the patient'sabdominal wall, minimally invasive instruments may be inserted into thepatient's anatomy. In some embodiments, the minimally invasiveinstruments comprise an elongated rigid member, such as a shaft, whichis used to access anatomy within the patient. After inflation of thepatient's abdominal cavity, the instruments may be directed to performsurgical or medical tasks, such as grasping, cutting, ablating,suturing, etc. In some embodiments, the instruments can comprise ascope, such as a laparoscope. FIG. 9 illustrates an embodiment of arobotically enabled table-based system configured for a laparoscopicprocedure. As shown in FIG. 9 , the carriages 43 of the system 36 may berotated and vertically adjusted to position pairs of the robotic arms 39on opposite sides of the table 38, such that instrument 59 may bepositioned using the arm mounts 45 to be passed through minimalincisions on both sides of the patient to reach his/her abdominalcavity.

To accommodate laparoscopic procedures, the robotically enabled tablesystem may also tilt the platform to a desired angle. FIG. 10illustrates an embodiment of the robotically enabled medical system withpitch or tilt adjustment. As shown in FIG. 10 , the system 36 mayaccommodate tilt of the table 38 to position one portion of the table ata greater distance from the floor than the other. Additionally, the armmounts 45 may rotate to match the tilt such that the arms 39 maintainthe same planar relationship with table 38. To accommodate steeperangles, the column 37 may also include telescoping portions 60 thatallow vertical extension of column 37 to keep the table 38 from touchingthe floor or colliding with base 46.

FIG. 11 provides a detailed illustration of the interface between thetable 38 and the column 37. Pitch rotation mechanism 61 may beconfigured to alter the pitch angle of the table 38 relative to thecolumn 37 in multiple degrees of freedom. The pitch rotation mechanism61 may be enabled by the positioning of orthogonal axes 1, 2 at thecolumn-table interface, each axis actuated by a separate motor 3, 4responsive to an electrical pitch angle command. Rotation along onescrew 5 would enable tilt adjustments in one axis 1, while rotationalong the other screw 6 would enable tilt adjustments along the otheraxis 2. In some embodiments, a ball joint can be used to alter the pitchangle of the table 38 relative to the column 37 in multiple degrees offreedom.

For example, pitch adjustments are particularly useful when trying toposition the table in a Trendelenburg position, i.e., position thepatient's lower abdomen at a higher position from the floor than thepatient's lower abdomen, for lower abdominal surgery. The Trendelenburgposition causes the patient's internal organs to slide towards his/herupper abdomen through the force of gravity, clearing out the abdominalcavity for minimally invasive tools to enter and perform lower abdominalsurgical or medical procedures, such as laparoscopic prostatectomy.

FIGS. 12 and 13 illustrate isometric and end views of an alternativeembodiment of a table-based surgical robotics system 100. The surgicalrobotics system 100 includes one or more adjustable arm supports 105that can be configured to support one or more robotic arms (see, forexample, FIG. 14 ) relative to a table 101. In the illustratedembodiment, a single adjustable arm support 105 is shown, though anadditional arm support can be provided on an opposite side of the table101. The adjustable arm support 105 can be configured so that it canmove relative to the table 101 to adjust and/or vary the position of theadjustable arm support 105 and/or any robotic arms mounted theretorelative to the table 101. For example, the adjustable arm support 105may be adjusted one or more degrees of freedom relative to the table101. The adjustable arm support 105 provides high versatility to thesystem 100, including the ability to easily stow the one or moreadjustable arm supports 105 and any robotics arms attached theretobeneath the table 101. The adjustable arm support 105 can be elevatedfrom the stowed position to a position below an upper surface of thetable 101. In other embodiments, the adjustable arm support 105 can beelevated from the stowed position to a position above an upper surfaceof the table 101.

The adjustable arm support 105 can provide several degrees of freedom,including lift, lateral translation, tilt, etc. In the illustratedembodiment of FIGS. 12 and 13 , the arm support 105 is configured withfour degrees of freedom, which are illustrated with arrows in FIG. 12 .A first degree of freedom allows for adjustment of the adjustable armsupport 105 in the z-direction (“Z-lift”). For example, the adjustablearm support 105 can include a carriage 109 configured to move up or downalong or relative to a column 102 supporting the table 101. A seconddegree of freedom can allow the adjustable arm support 105 to tilt. Forexample, the adjustable arm support 105 can include a rotary joint,which can allow the adjustable arm support 105 to be aligned with thebed in a Trendelenburg position. A third degree of freedom can allow theadjustable arm support 105 to “pivot up,” which can be used to adjust adistance between a side of the table 101 and the adjustable arm support105. A fourth degree of freedom can permit translation of the adjustablearm support 105 along a longitudinal length of the table.

The surgical robotics system 100 in FIGS. 12 and 13 can comprise a tablesupported by a column 102 that is mounted to a base 103. The base 103and the column 102 support the table 101 relative to a support surface.A floor axis 131 and a support axis 133 are shown in FIG. 13 .

The adjustable arm support 105 can be mounted to the column 102. Inother embodiments, the arm support 105 can be mounted to the table 101or base 103. The adjustable arm support 105 can include a carriage 109,a bar or rail connector 111 and a bar or rail 107. In some embodiments,one or more robotic arms mounted to the rail 107 can translate and moverelative to one another.

The carriage 109 can be attached to the column 102 by a first joint 113,which allows the carriage 109 to move relative to the column 102 (e.g.,such as up and down a first or vertical axis 123). The first joint 113can provide the first degree of freedom (“Z-lift”) to the adjustable armsupport 105. The adjustable arm support 105 can include a second joint115, which provides the second degree of freedom (tilt) for theadjustable arm support 105. The adjustable arm support 105 can include athird joint 117, which can provide the third degree of freedom (“pivotup”) for the adjustable arm support 105. An additional joint 119 (shownin FIG. 13 ) can be provided that mechanically constrains the thirdjoint 117 to maintain an orientation of the rail 107 as the railconnector 111 is rotated about a third axis 127. The adjustable armsupport 105 can include a fourth joint 121, which can provide a fourthdegree of freedom (translation) for the adjustable arm support 105 alonga fourth axis 129.

FIG. 14 illustrates an end view of the surgical robotics system 140Awith two adjustable arm supports 105A, 105B mounted on opposite sides ofa table 101. A first robotic arm 142A is attached to the bar or rail107A of the first adjustable arm support 105B. The first robotic arm142A includes a base 144A attached to the rail 107A. The distal end ofthe first robotic arm 142A includes an instrument drive mechanism 146Athat can attach to one or more robotic medical instruments or tools.Similarly, the second robotic arm 142B includes a base 144B attached tothe rail 107B. The distal end of the second robotic arm 142B includes aninstrument drive mechanism 146B. The instrument drive mechanism 146B canbe configured to attach to one or more robotic medical instruments ortools.

In some embodiments, one or more of the robotic arms 142A, 142Bcomprises an arm with seven or more degrees of freedom. In someembodiments, one or more of the robotic arms 142A, 142B can includeeight degrees of freedom, including an insertion axis (one degree offreedom, including insertion), a wrist (three degrees of freedom,including wrist pitch, yaw, and roll), an elbow (one degree of freedom,including elbow pitch), a shoulder (two degrees of freedom, includingshoulder pitch and yaw), and base 144A, 144B (one degree of freedom,including translation). In some embodiments, the insertion degree offreedom can be provided by the robotic arm 142A, 142B, while in otherembodiments, the instrument itself provides insertion via aninstrument-based insertion architecture.

C. Instrument Driver & Interface.

The end effectors of the system's robotic arms comprise (i) aninstrument driver (alternatively referred to as “instrument drivemechanism” or “instrument device manipulator”) that incorporateelectro-mechanical means for actuating the medical instrument and (ii) aremovable or detachable medical instrument, which may be devoid of anyelectro-mechanical components, such as motors. This dichotomy may bedriven by the need to sterilize medical instruments used in medicalprocedures, and the inability to adequately sterilize expensive capitalequipment due to their intricate mechanical assemblies and sensitiveelectronics. Accordingly, the medical instruments may be designed to bedetached, removed, and interchanged from the instrument driver (and thusthe system) for individual sterilization or disposal by the physician orthe physician's staff. In contrast, the instrument drivers need not bechanged or sterilized, and may be draped for protection.

FIG. 15 illustrates an example instrument driver. Positioned at thedistal end of a robotic arm, instrument driver 62 comprises of one ormore drive units 63 arranged with parallel axes to provide controlledtorque to a medical instrument via drive shafts 64. Each drive unit 63comprises an individual drive shaft 64 for interacting with theinstrument, a gear head 65 for converting the motor shaft rotation to adesired torque, a motor 66 for generating the drive torque, an encoder67 to measure the speed of the motor shaft and provide feedback to thecontrol circuitry, and control circuitry 68 for receiving controlsignals and actuating the drive unit. Each drive unit 63 beingindependent controlled and motorized, the instrument driver 62 mayprovide multiple (four as shown in FIG. 15 ) independent drive outputsto the medical instrument. In operation, the control circuitry 68 wouldreceive a control signal, transmit a motor signal to the motor 66,compare the resulting motor speed as measured by the encoder 67 with thedesired speed, and modulate the motor signal to generate the desiredtorque.

For procedures that require a sterile environment, the robotic systemmay incorporate a drive interface, such as a sterile adapter connectedto a sterile drape, that sits between the instrument driver and themedical instrument. The chief purpose of the sterile adapter is totransfer angular motion from the drive shafts of the instrument driverto the drive inputs of the instrument while maintaining physicalseparation, and thus sterility, between the drive shafts and driveinputs. Accordingly, an example sterile adapter may comprise of a seriesof rotational inputs and outputs intended to be mated with the driveshafts of the instrument driver and drive inputs on the instrument.Connected to the sterile adapter, the sterile drape, comprised of athin, flexible material such as transparent or translucent plastic, isdesigned to cover the capital equipment, such as the instrument driver,robotic arm, and cart (in a cart-based system) or table (in atable-based system). Use of the drape would allow the capital equipmentto be positioned proximate to the patient while still being located inan area not requiring sterilization (i.e., non-sterile field). On theother side of the sterile drape, the medical instrument may interfacewith the patient in an area requiring sterilization (i.e., sterilefield).

D. Medical Instrument.

FIG. 16 illustrates an example medical instrument with a pairedinstrument driver. Like other instruments designed for use with arobotic system, medical instrument 70 comprises an elongated shaft 71(or elongate body) and an instrument base 72. The instrument base 72,also referred to as an “instrument handle” due to its intended designfor manual interaction by the physician, may generally compriserotatable drive inputs 73, e.g., receptacles, pulleys or spools, thatare designed to be mated with drive outputs 74 that extend through adrive interface on instrument driver 75 at the distal end of robotic arm76. When physically connected, latched, and/or coupled, the mated driveinputs 73 of instrument base 72 may share axes of rotation with thedrive outputs 74 in the instrument driver 75 to allow the transfer oftorque from drive outputs 74 to drive inputs 73. In some embodiments,the drive outputs 74 may comprise splines that are designed to mate withreceptacles on the drive inputs 73.

The elongated shaft 71 is designed to be delivered through either ananatomical opening or lumen, e.g., as in endoscopy, or a minimallyinvasive incision, e.g., as in laparoscopy. The elongated shaft 71 maybe either flexible (e.g., having properties similar to an endoscope) orrigid (e.g., having properties similar to a laparoscope) or contain acustomized combination of both flexible and rigid portions. Whendesigned for laparoscopy, the distal end of a rigid elongated shaft maybe connected to an end effector extending from a jointed wrist formedfrom a clevis with at least one degree of freedom and a surgical tool ormedical instrument, such as, for example, a grasper or scissors, thatmay be actuated based on force from the tendons as the drive inputsrotate in response to torque received from the drive outputs 74 of theinstrument driver 75. When designed for endoscopy, the distal end of aflexible elongated shaft may include a steerable or controllable bendingsection that may be articulated and bent based on torque received fromthe drive outputs 74 of the instrument driver 75.

Torque from the instrument driver 75 is transmitted down the elongatedshaft 71 using tendons along the shaft 71. These individual tendons,such as pull wires, may be individually anchored to individual driveinputs 73 within the instrument handle 72. From the handle 72, thetendons are directed down one or more pull lumens along the elongatedshaft 71 and anchored at the distal portion of the elongated shaft 71,or in the wrist at the distal portion of the elongated shaft. During asurgical procedure, such as a laparoscopic, endoscopic or hybridprocedure, these tendons may be coupled to a distally mounted endeffector, such as a wrist, grasper, or scissor. Under such anarrangement, torque exerted on drive inputs 73 would transfer tension tothe tendon, thereby causing the end effector to actuate in some way. Insome embodiments, during a surgical procedure, the tendon may cause ajoint to rotate about an axis, thereby causing the end effector to movein one direction or another. Alternatively, the tendon may be connectedto one or more jaws of a grasper at distal end of the elongated shaft71, where tension from the tendon cause the grasper to close.

In endoscopy, the tendons may be coupled to a bending or articulatingsection positioned along the elongated shaft 71 (e.g., at the distalend) via adhesive, control ring, or other mechanical fixation. Whenfixedly attached to the distal end of a bending section, torque exertedon drive inputs 73 would be transmitted down the tendons, causing thesofter, bending section (sometimes referred to as the articulablesection or region) to bend or articulate. Along the non-bendingsections, it may be advantageous to spiral or helix the individual pulllumens that direct the individual tendons along (or inside) the walls ofthe endoscope shaft to balance the radial forces that result fromtension in the pull wires. The angle of the spiraling and/or spacingthere between may be altered or engineered for specific purposes,wherein tighter spiraling exhibits lesser shaft compression under loadforces, while lower amounts of spiraling results in greater shaftcompression under load forces, but also exhibits limits bending. On theother end of the spectrum, the pull lumens may be directed parallel tothe longitudinal axis of the elongated shaft 71 to allow for controlledarticulation in the desired bending or articulable sections.

In endoscopy, the elongated shaft 71 houses a number of components toassist with the robotic procedure. The shaft may comprise of a workingchannel for deploying surgical tools (or medical instruments),irrigation, and/or aspiration to the operative region at the distal endof the shaft 71. The shaft 71 may also accommodate wires and/or opticalfibers to transfer signals to/from an optical assembly at the distaltip, which may include of an optical camera. The shaft 71 may alsoaccommodate optical fibers to carry light from proximally located lightsources, such as light emitting diodes, to the distal end of the shaft.

At the distal end of the instrument 70, the distal tip may also comprisethe opening of a working channel for delivering tools for diagnosticand/or therapy, irrigation, and aspiration to an operative site. Thedistal tip may also include a port for a camera, such as a fiberscope ora digital camera, to capture images of an internal anatomical space.Relatedly, the distal tip may also include ports for light sources forilluminating the anatomical space when using the camera.

In the example of FIG. 16 , the drive shaft axes, and thus the driveinput axes, are orthogonal to the axis of the elongated shaft. Thisarrangement, however, complicates roll capabilities for the elongatedshaft 71. Rolling the elongated shaft 71 along its axis while keepingthe drive inputs 73 static results in undesirable tangling of thetendons as they extend off the drive inputs 73 and enter pull lumenswithin the elongated shaft 71. The resulting entanglement of suchtendons may disrupt any control algorithms intended to predict movementof the flexible elongated shaft during an endoscopic procedure.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument. As shown, a circular instrumentdriver 80 comprises four drive units with their drive outputs 81 alignedin parallel at the end of a robotic arm 82. The drive units, and theirrespective drive outputs 81, are housed in a rotational assembly 83 ofthe instrument driver 80 that is driven by one of the drive units withinthe assembly 83. In response to torque provided by the rotational driveunit, the rotational assembly 83 rotates along a circular bearing thatconnects the rotational assembly 83 to the non-rotational portion 84 ofthe instrument driver. Power and controls signals may be communicatedfrom the non-rotational portion 84 of the instrument driver 80 to therotational assembly 83 through electrical contacts may be maintainedthrough rotation by a brushed slip ring connection (not shown). In otherembodiments, the rotational assembly 83 may be responsive to a separatedrive unit that is integrated into the non-rotatable portion 84, andthus not in parallel to the other drive units. The rotational mechanism83 allows the instrument driver 80 to rotate the drive units, and theirrespective drive outputs 81, as a single unit around an instrumentdriver axis 85.

Like earlier disclosed embodiments, an instrument 86 may comprise anelongated shaft portion 88 and an instrument base 87 (shown with atransparent external skin for discussion purposes) comprising aplurality of drive inputs 89 (such as receptacles, pulleys, and spools)that are configured to receive the drive outputs 81 in the instrumentdriver 80. Unlike prior disclosed embodiments, instrument shaft 88extends from the center of instrument base 87 with an axis substantiallyparallel to the axes of the drive inputs 89, rather than orthogonal asin the design of FIG. 16 .

When coupled to the rotational assembly 83 of the instrument driver 80,the medical instrument 86, comprising instrument base 87 and instrumentshaft 88, rotates in combination with the rotational assembly 83 aboutthe instrument driver axis 85. Since the instrument shaft 88 ispositioned at the center of instrument base 87, the instrument shaft 88is coaxial with instrument driver axis 85 when attached. Thus, rotationof the rotational assembly 83 causes the instrument shaft 88 to rotateabout its own longitudinal axis. Moreover, as the instrument base 87rotates with the instrument shaft 88, any tendons connected to the driveinputs 89 in the instrument base 87 are not tangled during rotation.Accordingly, the parallelism of the axes of the drive outputs 81, driveinputs 89, and instrument shaft 88 allows for the shaft rotation withouttangling any control tendons.

FIG. 18 illustrates an instrument having an instrument based insertionarchitecture in accordance with some embodiments. The instrument 150 canbe coupled to any of the instrument drivers discussed above. Theinstrument 150 comprises an elongated shaft 152, an end effector 162connected to the shaft 152, and a handle 170 coupled to the shaft 152.The elongated shaft 152 comprises a tubular member having a proximalportion 154 and a distal portion 156. The elongated shaft 152 comprisesone or more channels or grooves 158 along its outer surface. The grooves158 are configured to receive one or more wires or cables 180therethrough. One or more cables 180 thus run along an outer surface ofthe elongated shaft 152. In other embodiments, cables 180 can also runthrough the elongated shaft 152. Manipulation of the one or more cables180 (e.g., via an instrument driver) results in actuation of the endeffector 162.

The instrument handle 170, which may also be referred to as aninstrument base, may generally comprise an attachment interface 172having one or more mechanical inputs 174, e.g., receptacles, pulleys orspools, that are designed to be reciprocally mated with one or moretorque couplers on an attachment surface of an instrument driver.

In some embodiments, the instrument 150 comprises a series of pulleys orcables that enable the elongated shaft 152 to translate relative to thehandle 170. In other words, the instrument 150 itself comprises aninstrument-based insertion architecture that accommodates insertion ofthe instrument, thereby minimizing the reliance on a robot arm toprovide insertion of the instrument 150. In other embodiments, a roboticarm can be largely responsible for instrument insertion.

E. Controller.

Any of the robotic systems described herein can include an input deviceor controller for manipulating an instrument attached to a robotic arm.In some embodiments, the controller can be coupled (e.g.,communicatively, electronically, electrically, wirelessly and/ormechanically) with an instrument such that manipulation of thecontroller causes a corresponding manipulation of the instrument e.g.,via master slave control.

FIG. 19 is a perspective view of an embodiment of a controller 182. Inthe present embodiment, the controller 182 comprises a hybrid controllerthat can have both impedance and admittance control. In otherembodiments, the controller 182 can utilize just impedance or passivecontrol. In other embodiments, the controller 182 can utilize justadmittance control. By being a hybrid controller, the controller 182advantageously can have a lower perceived inertia while in use.

In the illustrated embodiment, the controller 182 is configured to allowmanipulation of two medical instruments, and includes two handles 184.Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 isconnected to a positioning platform 188.

As shown in FIG. 19 , each positioning platform 188 includes a SCARA arm(selective compliance assembly robot arm) 198 coupled to a column 194 bya prismatic joint 196. The prismatic joints 196 are configured totranslate along the column 194 (e.g., along rails 197) to allow each ofthe handles 184 to be translated in the z-direction, providing a firstdegree of freedom. The SCARA arm 198 is configured to allow motion ofthe handle 184 in an x-y plane, providing two additional degrees offreedom.

In some embodiments, one or more load cells are positioned in thecontroller. For example, in some embodiments, a load cell (not shown) ispositioned in the body of each of the gimbals 186. By providing a loadcell, portions of the controller 182 are capable of operating underadmittance control, thereby advantageously reducing the perceivedinertia of the controller while in use. In some embodiments, thepositioning platform 188 is configured for admittance control, while thegimbal 186 is configured for impedance control. In other embodiments,the gimbal 186 is configured for admittance control, while thepositioning platform 188 is configured for impedance control.Accordingly, for some embodiments, the translational or positionaldegrees of freedom of the positioning platform 188 can rely onadmittance control, while the rotational degrees of freedom of thegimbal 186 rely on impedance control.

F. Navigation and Control.

Traditional endoscopy may involve the use of fluoroscopy (e.g., as maybe delivered through a C-arm) and other forms of radiation-based imagingmodalities to provide endoluminal guidance to an operator physician. Incontrast, the robotic systems contemplated by this disclosure canprovide for non-radiation-based navigational and localization means toreduce physician exposure to radiation and reduce the amount ofequipment within the operating room. As used herein, the term“localization” may refer to determining and/or monitoring the positionof objects in a reference coordinate system. Technologies such aspre-operative mapping, computer vision, real-time EM tracking, and robotcommand data may be used individually or in combination to achieve aradiation-free operating environment. In other cases, whereradiation-based imaging modalities are still used, the pre-operativemapping, computer vision, real-time EM tracking, and robot command datamay be used individually or in combination to improve upon theinformation obtained solely through radiation-based imaging modalities.

FIG. 20 is a block diagram illustrating a localization system 90 thatestimates a location of one or more elements of the robotic system, suchas the location of the instrument, in accordance to an exampleembodiment. The localization system 90 may be a set of one or morecomputer devices configured to execute one or more instructions. Thecomputer devices may be embodied by a processor (or processors) andcomputer-readable memory in one or more components discussed above. Byway of example and not limitation, the computer devices may be in thetower 30 shown in FIG. 1 , the cart shown in FIGS. 1-4 , the beds shownin FIGS. 5-14 , etc.

As shown in FIG. 20 , the localization system 90 may include alocalization module 95 that processes input data 91-94 to generatelocation data 96 for the distal tip of a medical instrument. Thelocation data 96 may be data or logic that represents a location and/ororientation of the distal end of the instrument relative to a frame ofreference. The frame of reference can be a frame of reference relativeto the anatomy of the patient or to a known object, such as an EM fieldgenerator (see discussion below for the EM field generator).

The various input data 91-94 are now described in greater detail.Pre-operative mapping may be accomplished through the use of thecollection of low dose CT scans. Pre-operative CT scans arereconstructed into three-dimensional images, which are visualized, e.g.as “slices” of a cutaway view of the patient's internal anatomy. Whenanalyzed in the aggregate, image-based models for anatomical cavities,spaces and structures of the patient's anatomy, such as a patient lungnetwork, may be generated. Techniques such as center-line geometry maybe determined and approximated from the CT images to develop athree-dimensional volume of the patient's anatomy, referred to as modeldata 91 (also referred to as “preoperative model data” when generatedusing only preoperative CT scans). The use of center-line geometry isdiscussed in U.S. patent application Ser. No. 14/523,760, the contentsof which are herein incorporated in its entirety. Network topologicalmodels may also be derived from the CT-images, and are particularlyappropriate for bronchoscopy.

In some embodiments, the instrument may be equipped with a camera toprovide vision data 92. The localization module 95 may process thevision data to enable one or more vision-based location tracking. Forexample, the preoperative model data may be used in conjunction with thevision data 92 to enable computer vision-based tracking of the medicalinstrument (e.g., an endoscope or an instrument advance through aworking channel of the endoscope). For example, using the preoperativemodel data 91, the robotic system may generate a library of expectedendoscopic images from the model based on the expected path of travel ofthe endoscope, each image linked to a location within the model.Intra-operatively, this library may be referenced by the robotic systemin order to compare real-time images captured at the camera (e.g., acamera at a distal end of the endoscope) to those in the image libraryto assist localization.

Other computer vision-based tracking techniques use feature tracking todetermine motion of the camera, and thus the endoscope. Some features ofthe localization module 95 may identify circular geometries in thepreoperative model data 91 that correspond to anatomical lumens andtrack the change of those geometries to determine which anatomical lumenwas selected, as well as the relative rotational and/or translationalmotion of the camera. Use of a topological map may further enhancevision-based algorithms or techniques.

Optical flow, another computer vision-based technique, may analyze thedisplacement and translation of image pixels in a video sequence in thevision data 92 to infer camera movement. Examples of optical flowtechniques may include motion detection, object segmentationcalculations, luminance, motion compensated encoding, stereo disparitymeasurement, etc. Through the comparison of multiple frames overmultiple iterations, movement and location of the camera (and thus theendoscope) may be determined.

The localization module 95 may use real-time EM tracking to generate areal-time location of the endoscope in a global coordinate system thatmay be registered to the patient's anatomy, represented by thepreoperative model. In EM tracking, an EM sensor (or tracker) comprisingof one or more sensor coils embedded in one or more locations andorientations in a medical instrument (e.g., an endoscopic tool) measuresthe variation in the EM field created by one or more static EM fieldgenerators positioned at a known location. The location informationdetected by the EM sensors is stored as EM data 93. The EM fieldgenerator (or transmitter), may be placed close to the patient to createa low intensity magnetic field that the embedded sensor may detect. Themagnetic field induces small currents in the sensor coils of the EMsensor, which may be analyzed to determine the distance and anglebetween the EM sensor and the EM field generator. These distances andorientations may be intra-operatively “registered” to the patientanatomy (e.g., the preoperative model) in order to determine thegeometric transformation that aligns a single location in the coordinatesystem with a position in the pre-operative model of the patient'sanatomy. Once registered, an embedded EM tracker in one or morepositions of the medical instrument (e.g., the distal tip of anendoscope) may provide real-time indications of the progression of themedical instrument through the patient's anatomy.

Robotic command and kinematics data 94 may also be used by thelocalization module to provide localization data 96 for the roboticsystem. Device pitch and yaw resulting from articulation commands may bedetermined during pre-operative calibration. Intra-operatively, thesecalibration measurements may be used in combination with known insertiondepth information to estimate the position of the instrument.Alternatively, these calculations may be analyzed in combination withEM, vision, and/or topological modeling to estimate the position of themedical instrument within the network.

As FIG. 20 shows, a number of other input data can be used by thelocalization module 95. For example, although not shown in FIG. 20 , aninstrument utilizing shape-sensing fiber can provide shape data that thelocalization module 95 can use to determine the location and shape ofthe instrument.

The localization module 95 may use the input data 91-94 incombination(s). In some cases, such a combination may use aprobabilistic approach where the localization module 95 assigns aconfidence weight to the location determined from each of the input data91-94. Thus, where the EM data may not be reliable (as may be the casewhere there is EM interference) the confidence of the locationdetermined by the EM data 93 can be decrease and the localization module95 may rely more heavily on the vision data 92 and/or the roboticcommand and kinematics data 94.

As discussed above, the robotic systems discussed herein may be designedto incorporate a combination of one or more of the technologies above.The robotic system's computer-based control system, based in the tower,bed and/or cart, may store computer program instructions, for example,within a non-transitory computer-readable storage medium such as apersistent magnetic storage drive, solid state drive, or the like, that,upon execution, cause the system to receive and analyze sensor data anduser commands, generate control signals throughout the system, anddisplay the navigational and localization data, such as the position ofthe instrument within the global coordinate system, anatomical map, etc.

2. Transport of Surgical Systems.

Some embodiments of the disclosure include systems related to surgicalsystems, and more particularly to systems for transporting and securinga surgical robotic system.

A console of a surgical robotic system, such as a physician's interfaceconsole, can include casters to allow the movement of the console. Thecasters may swivel to allow the console to be turned or otherwisemaneuvered. In some applications, the swiveling functionality of certainconventional casters may allow the caster wheels to unintentionallyswivel during forward or backward travel.

After transporting the console, the casters of the console can bestopped or otherwise locked into position prior to a surgical procedureto prevent inadvertent movement of the console. For example, the castersmay be stopped to prevent movement of the console while a surgeon isoperating the human interface devices (HIDs) of the console. In someapplications, certain conventional consoles may only lock one casterwheel of the caster assembly. Further, in some applications, certainconventional consoles may not provide any indication of when a caster islocked or unlocked.

Caster assemblies disclosed herein can overcome one or more challengesdiscovered with respect to certain conventional caster assemblies. Forexample, in accordance with some embodiments disclosed herein, thepresent inventor's analysis led to the discovery of variousrealizations, deficiencies, and problematic features of prior artsystems, some of which are presented herein, including the followingrealizations.

First, the present disclosure includes the realization thatunintentional swiveling of the caster wheels can prevent a technicianfrom easily or safely moving the console forwards or backwards withoutthe console drifting laterally or wobbling. Further, certainconventional consoles with uneven distributions of mass may be morelikely to laterally drift or wobble during transport. Additionally,certain conventional consoles may be designed and tested to betransported by a technician within a certain height and weightpercentile, such that a technician's force is aligned with the center ofmass of the console. Therefore, certain conventional consoles may bemore likely to laterally drift or wobble during transport if transportedby a technician that falls outside the design parameters (e.g. atechnician that is shorter or lighter than the design criteria).Accordingly, some embodiments disclosed herein can provide casterassemblies having features that address one or more of these issues andminimize unintentional swiveling of the caster wheels. In someembodiments, the caster assembly described herein can implement a pedalactuated mechanism to selectively allow the caster wheels to freelyswivel or rotate while locked in a desired alignment.

Second, the present disclosure includes the realization that locking asingle caster wheel of a caster assembly may still allow the console tounintentionally move or be placed in an unstable state due to contactwith the console during a surgical procedure or otherwise when a surgeonis interfacing with the console, which may also negatively affect asurgical procedure. Accordingly, some embodiments disclosed herein canprovide caster assemblies having features that address one or more ofthese issues and securely position the console during a surgicalprocedure by locking multiple caster wheels. In some embodiments, thecaster assembly described herein can implement a pedal actuatedmechanism to selectively brake multiple caster wheels of the casterassembly simultaneously.

Third, the present disclosure includes the realization that becausecertain conventional consoles do not provide a status or indication if acaster wheel is locked or unlocked, an inexperienced user may operate orinterface with the console without locking the casters, which may causethe console to move due to unintentional contact with the console andnegatively affect the surgical procedure. Accordingly, some embodimentsdisclosed herein can provide caster assemblies having features thataddress one or more of these issues and provide an indication if thecaster wheels are locked. In some embodiments the caster assembly canimplement a system or method to detect the position of the pedal and/orthe status of the brakes to determine if the caster wheels are locked orunlocked. In some embodiments, the caster assembly can implement asystem or method to prevent the console from being used in a surgicaloperation until the console is locked into position and the casterwheels are locked.

FIG. 21 illustrates a perspective view of a console 200. In the depictedexample, the console 200 can allow a surgeon or other clinician toperform a surgical procedure or otherwise control operations of asurgical robotic system. In some embodiments, the console 200 can be aphysician's interface console that allows a surgeon to controloperations of the surgical robotic system via one or more humaninterface devices 201. The console 200 may include features that aresimilar as features described with respect to console 31 herein.

FIG. 22 illustrates a perspective view of a caster assembly 210. FIG. 23illustrates a partial elevation view of the caster assembly 210 of FIG.22 with the lock members in an unlocked position. With reference toFIGS. 21-23 , the console 200 includes one or more caster assemblies 210that allow the console 200 to be transported between locations andsecured for a surgical procedure and/or storage. In the depictedexample, the console 200 can include a left caster assembly 210 and aright caster assembly 210 disposed on either side of the console 200 toallow transport and positioning of the console 200. As described herein,the caster assembly 210 includes at least two casters 220 that allow forthe console 200 to be moved between locations.

In the depicted example, the caster wheel 230 rotates relative to awheel housing 232, allowing the console 200 to be moved. As illustrated,the wheel housing 232 is coupled to the caster support 224 via a wheelsupport 222. In some embodiments, components of the caster 220 arefurther covered or obscured by a shroud 226. The caster support 224 canbe coupled to the console 200 to secure the caster assembly 210 to theconsole 200.

Further, in embodiments, the caster wheels 230 may be able to swivelrelative to the caster support 224 and the console 200 to allow theconsole 200 to be turned or maneuvered. In the depicted example, thewheel support 222 can be rotatably coupled to the caster support 224 toallow the wheel support 222 and in turn the caster wheel 230 to swivelrelative to the caster support 224. In some embodiments, the casterwheel 230 can swivel within the shroud 226.

As described herein, the caster assembly 210 further includes lockingmembers 240 to selectively brake or lock the caster wheels 230, securingthe console 200 in a desired position. Further, the caster assembly 210can include a direction locking mechanism 300 to selectively allow thecaster wheels 230 to swivel for increased maneuverability or be lockedin a desired alignment to allow the console 200 to be readily moved in astraight line. In the illustrated embodiment, the caster assembly 210includes one or more pedal assemblies 280, 282 to control the operationof the locking members 240 and the direction locking mechanism 300,respectively.

Optionally, some embodiments of the caster assembly 210 can comprise oneor more sensors that can detect the state of the pedal assembly 280 todetermine the whether the caster wheels 230 are locked or unlocked. Insome embodiments, the caster assembly 210 described herein can be usedwith any suitable console or component for use with a surgical roboticsystem.

FIG. 24 illustrates a partial elevation view of the caster assembly ofFIG. 22 with the lock members in a locked position. FIG. 25 illustratesan exploded perspective view of a lock member. With reference to FIGS.23-25 , the locking member 240 is movable to selectively engage with thecaster wheel 230, braking or locking the caster wheel 230 in position.In the depicted example, the locking member 240 is movable between anunlocked position (FIG. 23 ) wherein the locking member 240 is spacedapart from the caster wheel 230 to allow the caster wheel 230 to freelyrotate and a locked position (FIG. 24 ) where the locking member 240engages with the caster wheel 230 with sufficient force to preventrotation of the caster wheel 230 and/or prevent movement of an attachedconsole. As described herein, multiple locking members 240 canselectively engage with multiple respective caster wheels 230 to controlthe rotation of each caster wheel 230.

In the depicted example, the locking member 240 includes a brake portion252 configured to frictionally engage with the caster wheel 230 to slowor stop rotation. The brake portion 252 can be formed from a materialconfigured to generate a desired frictional force when in contact withthe caster wheel 230. As illustrated, the brake portion 252 can beformed as lock ring 250 with an opening 254 therethrough.Advantageously, the annular construction of the lock ring 250 can allowthe wheel support 222 to pass through the opening 254, permitting thecaster wheel 230 to swivel relative to the lock ring 250, while stillallowing the brake portion 252 of the lock ring 250 to engage with thecaster wheel 230 regardless of the swivel or rotational position of thecaster wheel 230. In some embodiments, the lock ring 250 can have agenerally circular profile. Optionally, the lock ring 250 can have anoval or egg shaped profile, which may permit an even distribution ofbraking force regardless of the swivel or rotational position of thecaster wheel 230.

During operation, the brake portion 252 (or the lock ring 250,generally) can move relative to the caster wheel 230, engaging and/ordisengaging the brake portion 252 from the caster wheel 230. FIG. 26illustrates a partial perspective view of the caster assembly 210 ofFIG. 22 . With reference to FIGS. 25 and 26 , the lock ring 250 canrotate about a pivot pin 245, permitting the brake portion 252 to rotatein and out of engagement with the caster wheel 230 about an axis ofrotation defined by the pivot pin 245. As illustrated, the lock ring 250defines a pivot component 246 to receive the pivot pin 245 and rotatablycouple the lock ring 250 to the pivot pin 245.

In some embodiments, variances or tolerances in the caster assembly 210may result in inconsistent or varying braking force applied by the brakeportion 252 against the caster wheel 230. Optionally, the axis ofrotation of the lock ring 250 can be adjusted relative to the casterwheel 230 to ensure that a consistent and/or desired force is applied bythe brake portion 252 on each caster wheel 230. In the depicted example,the pivot pin 245 defining the axis of rotation of the lock ring 250 iscaptured or otherwise supported by a yoke 248 via legs 247. By adjustingor manipulating a vertical position of the yoke 248 relative to thecaster wheel 230, the position of the pivot pin 245, and therefore theaxis of rotation of the lock ring 250, is adjusted relative to thecaster wheel 230. In some embodiments, the yoke 248 can be adjustablycoupled to the shroud 226. The vertical position of the yoke 248relative to the shroud 226 (and the caster wheel 230) may be adjusted bytightening or loosening an adjustment screw. The adjustment screw mayinclude a lock nut to maintain the vertical position of the yoke 248after adjustment.

In the depicted example, the brake portion 252 can be moved or rotatedrelative to the caster wheel 230 by applying force to or moving anextension portion 242 extending from the lock ring 250. As illustratedin at least FIG. 25 , the extension portion 242 can extend from the lockring 250 in a direction opposite to the pivot component 246. In someembodiments, an end portion 243 of the extension portion 242 can bemoved to move or actuate the brake portion 252 relative to the casterwheel 230. Optionally, the length of the extension portion 242 and/orthe position of the end portion 243 relative to the brake portion 252can be configured to multiply the force applied by the user to the brakeportion 252 by a desired factor. Similarly, the length of the extensionportion 242 and/or the position of the end portion 243 relative to thebrake portion 252 can be configured to adjust the travel required by theuser to engage or disengage the brake portion 252 relative to the casterwheel 230.

FIG. 27 illustrates a partial exploded perspective view of the lockmembers 240 and the pedal assembly 280. With reference to FIGS. 23-25,and 27 , one or more lock members 240 can be moved or otherwise actuatedby a lock plate 260 to engage or disengage the brake portion 252relative to a caster wheel 230. As illustrated, multiple lock members240 (e.g. two lock members 240) can be moved or actuated by a singlecommon lock plate 260 to engage or disengage a brake portion 252relative to a respective caster wheel 230. As illustrated in FIG. 23 ,the lock plate 260 can be moved upward to disengage the brake portion252 of the respective lock member 240 from the respective caster wheel230. As illustrated in FIG. 24 , the lock plate 260 can be moveddownward to engage the brake portion 252 of a respective lock member 240against a respective caster wheel 230.

In some embodiments, an end portion 243 of each respective lock member240 is coupled to the lock plate 260 via one or more fasteners 264extending through holes 244 of the lock member 240 and holes 262 of thelock plate 260. During operation, the lock members 240 can rotate aroundthe fasteners 264 and relative to the lock plate 260 as the lock plate260 is translated. As described above, variances or tolerances in thecaster assembly 210 may result in inconsistent or varying braking forceapplied by the brake portion 252 against the caster wheel 230.

In some embodiments, the amount of travel for the lock members 240between the unlocked and locked position can change based on the swivelor rotational position of each caster wheel 230, since the rotationalposition of each caster wheel 230 may alter the point of contact orpivot location between the lock member 240 and the respective casterwheel 230. Therefore, in some embodiments, the lock members 240 can becoupled to the lock plate 260 via an extension spring 266 to correct fordifferences in travel between the unlocked and locked position as theswivel or rotational position of the caster wheels 230 is changed.During operation, the extension spring 266 can extend or contractrelative to the lock plate 260 to adjust for the amount of travel neededto move the lock members 240 between the unlocked and locked positionsdepending on the swivel or rotational position of the respective casterwheel 230. Optionally, one end of the extension spring 266 may becoupled to the lock plate 260 via one or more fasteners 264 extendingthrough holes 262 of the lock plate 260 and the other end of theextension spring 266 may be coupled to the end portion 243 of the lockmember 240 via one or more fasteners 264 extending through holes 244 ofthe lock member.

FIG. 28 illustrates a perspective view of a caster assembly 210. FIG. 29illustrates a partial exploded perspective view of the pedal assemblies280, 282. FIG. 30 illustrates a perspective view of a pedal assembly280. FIG. 31 illustrates a rear elevation view of the pedal assembly280.

With reference to FIGS. 28-31 , the pedal assembly 280 allows a user tolock and unlock the caster wheels 230 of the caster assembly 210. In thedepicted example, the pedal assembly 280 moves the lock plate 260 tocontrol the position of the lock members 240, and in turn the brakeportions 252 relative to the respective caster wheels 230.Advantageously, a user can selectively brake multiple caster wheels 230simultaneously by actuating a single pedal assembly 280, preventing theconsole 200 from moving unintentionally or being placed in an unstablestate during a surgical procedure or otherwise when a surgeon isinterfacing with the console 200.

As illustrated, the pedal body 281 is coupled to the lock plate 260 topermit movement of the pedal body 281 to translate the lock plate 260.In the depicted example, the pedal body 281 is translatable or otherwisemovable relative to the base frame 272 of the base assembly 270. In someembodiments, the pedal body 281 is coupled to the base frame 272 by alinear guide 274 to constrain the motion of the pedal body 281 tovertical translation. During operation, a user can depress the pedalbody 281 by applying force to a pedal cover 286 affixed or otherwisecoupled to a top portion of the pedal body 281. The pedal cover 286 caninclude a broad surface with one or more optional ridges to allow a userto easily step on the pedal cover 286 to depress or otherwise actuatethe pedal assembly 280 and engage the brake portions 252 against therespective caster wheels 230. Optionally, a biasing member, such as areturn spring can urge the pedal body 281 to an extended position anddisengage the brake portions 252 from the respective caster wheels 230.In some embodiments, the return spring can be a gas spring.

In some embodiments, the pedal assembly 280 can include a latch 285coupled to the pedal body 281 to retain the pedal body 281 (andtherefore the lock plate 260) in a depressed or locked position. In thedepressed position, the latch 285 can engage with the keep 284 coupledto the base frame 272 or other component that is stationary relative tothe pedal body 281 to retain the pedal body 281 in the depressedposition. In some embodiments, the engagement between the latch 285 andkeep 284 is configured to overcome or withstand the return force fromthe biasing member to retain the pedal body 281 in the depressedposition.

Optionally, the latch 285 can be disengaged from the keep 284 be furtherdepressing the pedal body 281 relative to the keep 284, permitting thereturn force from the biasing member to return the pedal body 281 to theextended position.

In some embodiments, the caster assembly 210 can include one or moresensors to detect if the caster wheels 230 are locked or unlocked. Sincethe position of the pedal body 281 corresponds to the position of thebrake portions 252 relative to the respective caster wheels 230, theposition of the pedal body 281 can be utilized to determine if thecaster wheels 230 are locked or unlocked. In the depicted example, thepedal assembly 280 may include one or more sensors 292 to detect theposition of the pedal body 281 relative to the base frame 272. Sensors292 may be coupled to the base frame 272 or disposed at any othersuitable surface to detect the position of the pedal body 281. In someembodiments, the sensors 292 may include one or more hall effectsensors. Advantageously, the use of sensors 292 can be prevent a userfrom inadvertently interfacing with the console 200 without locking thecaster wheels 230 in place, preventing the console 200 from movingduring a surgical procedure. In some embodiments, both the left casterassembly 210 and the right caster assembly 210 can include sensors 292to detect if the respective caster wheels 230 are locked or unlocked.

During operation, as the pedal body 281 is depressed or translateddownward relative to the base frame 272, the sensors 292 may detect achange in magnetic field as the pedal body 281 is moved toward a lockedposition to determine the depressed position of the pedal body 281 andthe locked state of the caster wheels 230. Similarly, the sensors 292may detect a change in magnetic field as the pedal body 281 istranslated upward to an unlocked position to determine the extendedposition of the pedal body 281 and the unlocked state of the casterwheels 230. In some embodiments, the pedal body 281 can include one,two, or more magnets 290 adhered, affixed, or otherwise coupled to thepedal body 281. In some embodiments, the pedal assembly 280 may includeredundant sensors 292. The sensors 292 may include other suitable typeof sensors including contact sensors, optical sensors, ultrasonicsensors, etc.

In some embodiments, information from the sensors 292 regarding theposition of the pedal body 281 can be used to notify the user of thecurrent lock state of the caster wheels 230 and/or prevent the use ofthe surgical robotic system while the caster wheels 230 are unlocked. Inthe depicted example, data from the sensors 292 can be provided to acontroller of the robotic surgical system to provide a notification tothe user that the caster wheels 230 are in a locked or unlocked state.In some embodiments, the robotic surgical system and/or the casterassembly 210 may provide an audible, visual, and/or tactile alert whenthe pedal body 281 is an extended position and/or the caster wheels 230are in an unlocked state.

Optionally, the alert provided may be dependent on the operationalstatus of the robotic surgical system. Further, in some embodiments, therobotic surgical system and/or the caster assembly 210 may prevent ordisable surgical procedures when the pedal body 281 is an extendedposition and/or the caster wheels 230 are in an unlocked state. In someembodiments, the robotic surgical system may prevent or disable surgicalprocedures when caster wheels 230 of either the left or right casterassembly 210 are in an unlocked state. Similarly, the robotic surgicalsystem and/or the caster assembly 210 may permit surgical procedureswhen the pedal body 281 is a depressed position and/or the caster wheels230 are in a locked state. In some embodiments, the robotic surgicalsystem may permit surgical procedures when the caster wheels 230 of boththe left and right caster assemblies 210 are in a locked state.

FIG. 32 illustrates a perspective view of a caster assembly 210 with thedirection locking mechanism 300 unlocked. FIG. 33 illustrates aperspective view of a caster assembly 210 with the direction lockingmechanism 300 locked. With reference to FIGS. 32 and 33 , the directionlocking mechanisms 300 can selectively allow the caster wheels 230swivel or remain in a desired alignment. In the depicted example, thedirection locking mechanism 300 is selectable between an unlockedposition (FIG. 32 ) wherein the direction locking mechanism 300 allowsthe caster wheel 230 to freely swivel (and rotate relative to the wheelsupport 222), and a locked position (FIG. 33 ) wherein the directionlocking mechanism 300 prevents the caster wheel 230 swiveling (withoutaffecting the rotation of the caster wheel 230 relative to the wheelsupport 222). As described herein, multiple direction locking mechanisms300 can be used selectively to control the swivel functionality of eachcaster wheel 230.

In some embodiments, the direction locking mechanism 300 selectivelyengages a raceway or other swiveling element of the caster wheel 230 topermit or prevent swiveling of the caster wheel 230. As describedherein, a wheel support 222 of a caster wheel 230 can rotate relative toa caster support 224 to allow the caster wheel 230 to swivel. In someembodiments, the direction locking mechanism 300 can selectively engageor couple a wheel support 222 of a caster wheel 230 with a respectivecaster support 224 to permit or prevent swiveling of the caster wheel230. In an unlocked position, the direction locking mechanism 300 canspace apart, decouple, or otherwise disengage a wheel support 222 fromthe caster support 224 to allow the wheel support 222 to swivelindependently of the caster support 224. In the locked position, thedirection locking mechanism 300 can couple or engage the wheel support222 with the caster support 224 to prevent the wheel support 222 frommoving or swiveling independently of the caster support 224. In someembodiments, the direction locking mechanism 300 can use any suitablemechanism to permit or prevent swiveling of the caster wheel 230.

In some embodiments, the unlocked and the locked position of thedirection locking mechanism 300 is selected by rotating a keyway 302.Optionally, the keyway 302 can be rotated a predetermined amount toselect the locked position from an unlocked position, or vice versa. Forexample, the keyway 302 may be rotated 30 degrees to be moved from anunlocked position to a locked position or from the locked position tothe unlocked position. As illustrated, the keyway 302 may be rotated bya hexagonal shaft or key 310 configured to interface with or apply arotational force to the keyway 302.

In the depicted example, the keyway 302 of one or more direction lockingmechanisms 300 can be operated or controlled from a spaced apartlocation via the key 310. As illustrated, the keyway 302 can be rotatedby the first end 312 of the key 310 by applying torque to any part ofthe key 310, including the second end 314 or any other portion,including middle portions of the key 310. Similarly, a keyway 302 of asecond direction locking mechanism 300 can be rotated by a second end314 of the key by applying torque to any part of the key 310, includingmiddle portions of the key 310. Therefore, in some embodiments, the key310 can simultaneously rotate the keyway 302 of multiple directionlocking mechanisms 300 via the first end 312 and the second end 314 ofthe key 310. Advantageously, by rotating the key 310 a user cansimultaneously lock or unlock the direction locking mechanisms 300corresponding to each caster wheel 230, allowing each caster wheel 230to be simultaneously permitted to be swiveled or locked in a certaindesired alignment.

FIG. 34 illustrates a side elevation view of a direction locking pedalassembly 282. FIG. 35 illustrates a partial perspective view of adirection locking pedal assembly 282. With reference to FIGS. 34 and 35, the pedal assembly 282 allows a user to selectively permit and preventswiveling of the caster wheels 230 of the caster assembly 210. In thedepicted example, the pedal assembly 282 rotates the key 310 to move thekeyway 302 of each direction locking mechanism 300 between an unlockedand locked position. Advantageously, a user can selectively allow thecaster wheels 230 to freely swivel to permit maneuvering of a console200 or lock the caster wheels 230 in a desired alignment to allow theconsole 200 to be moved forwards or backwards without the console 200drifting laterally or wobbling.

As illustrated, the pedal body 283 is coupled to the key 310 via alinkage 320 to permit movement or translation of the pedal body 283 torotate the key 310. In the depicted example, the pedal body 283 istranslatable or otherwise movable relative to the base frame 272 of thebase assembly 270. In some embodiments, the pedal body 283 is coupled tothe base frame 272 by a linear guide 276 to constrain the motion of thepedal body 283 to vertical translation. As illustrated, the linkage 320is coupled to the key 310 and is attached to the pedal body 283 via arotatable linkage pivot component 328. Therefore, as the pedal body 283translates vertically, the linkage 320 rotates relative to the pedalbody 283, rotating the key 310. In the depicted example, moving thepedal body 283 downward rotates the linkage 320 downward and rotates thekey 310 counter clockwise toward a lock position of the directionlocking mechanism 300. Moving the pedal body 283 upward rotates thelinkage 320 upward and rotates the key 310 clockwise toward an unlockposition of the direction locking mechanism 300.

In some embodiments, the linkage 320 may be mated or otherwise coupledto the key 310 by a linkage keyway 322 formed in the linkage 320,permitting the linkage 320 to rotate the key 310. In some embodimentsthe linkage keyway 322 includes a key slot 324 to permit the insertionand removal of the key 310 from the linkage 320.

As illustrated, the linkage pivot component 328 may be disposed in anelongated slot 326 to allow the linkage pivot component 328 to travel inan arc as the linkage 320 rotates, preventing binding between the pedalbody 283 and the linkage 320 as the pedal body 283 is translated. Thelinkage pivot component 328 may be captured or retained within theelongate slot 326 by a retaining clip 329.

During operation, a user can depress the pedal body 283 by applyingforce to a pedal cover 288 affixed or otherwise coupled to a top portionof the pedal body 283. The pedal cover 288 can include a broad surfacewith one or more optional ridges to allow a user to easily step on thepedal cover 288 to depress or otherwise actuate the pedal assembly 282and lock the caster wheels 230 in a desired swivel orientation. In someembodiments, the pedal cover 288 corresponding to the operation of thedirection locking mechanism 300 may be visually or tactilelydifferentiated from the pedal cover 286 corresponding to operation ofthe brake portions 252. Optionally, a biasing member, such as a returnspring can urge the pedal body 283 to an extended position and permitthe caster wheels 230 to freely swivel. In some embodiments, the returnspring can be a gas spring.

Similar to pedal assembly 280, the pedal assembly 282 can include alatch 285 coupled to the pedal body 283 to retain the pedal body 283(and therefore the key 310) in a depressed or locked position. In thedepressed position, the latch 285 can engage with the keep 284 coupledto the base frame 272 or other component that is stationary relative tothe pedal body 283 to retain the pedal body 283 in the depressedposition. In some embodiments, the engagement between the latch 285 andkeep 284 is configured to overcome or withstand the return force fromthe biasing member to retain the pedal body 283 in the depressedposition. Optionally, the latch 285 can be disengaged from the keep 284be further depressing the pedal body 283 relative to the keep 284,permitting the return force from the biasing member to return the pedalbody 283 to the extended position.

3. Implementing Systems and Terminology.

Implementations disclosed herein provide systems, methods and apparatusfor operatively coupling an obturator and a cannula.

It should be noted that the terms “couple,” “coupling,” “coupled,” orother variations of the word couple as used herein may indicate eitheran indirect connection or a direct connection. For example, if a firstcomponent is “coupled” to a second component, the first component may beeither indirectly connected to the second component via anothercomponent or directly connected to the second component.

The methods disclosed herein comprise one or more steps or actions forachieving the described method. The method steps and/or actions may beinterchanged with one another without departing from the scope of theclaims. In other words, unless a specific order of steps or actions isrequired for proper operation of the method that is being described, theorder and/or use of specific steps and/or actions may be modifiedwithout departing from the scope of the claims.

As used herein, the term “plurality” denotes two or more. For example, aplurality of components indicates two or more components. The term“determining” encompasses a wide variety of actions and, therefore,“determining” can include calculating, computing, processing, deriving,investigating, looking up (e.g., looking up in a table, a database oranother data structure), ascertaining and the like. Also, “determining”can include receiving (e.g., receiving information), accessing (e.g.,accessing data in a memory) and the like. Also, “determining” caninclude resolving, selecting, choosing, establishing and the like.

The phrase “based on” does not mean “based only on,” unless expresslyspecified otherwise. In other words, the phrase “based on” describesboth “based only on” and “based at least on.”

The previous description of the disclosed implementations is provided toenable any person skilled in the art to make or use the presentinventions. Various modifications to these implementations will bereadily apparent to those skilled in the art, and the generic principlesdefined herein may be applied to other implementations without departingfrom the scope of the inventions. For example, it will be appreciatedthat one of ordinary skill in the art will be able to employ a numbercorresponding alternative and equivalent structural details, such asequivalent ways of fastening, mounting, coupling, or engaging toolcomponents, equivalent mechanisms for producing particular actuationmotions, and equivalent mechanisms for delivering electrical energy.Thus, the present inventions are not intended to be limited to theimplementations shown herein but is to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

What is claimed is:
 1. A caster assembly for use with a surgicalconsole, the caster assembly comprising: a caster comprising a castersupport coupled to the surgical console and a caster wheel rotatablycoupled to the caster support; and a lock member comprising a pivotcomponent, an extension portion, and a brake portion coupled to thepivot component and the extension portion, the brake portion beingpivotably mounted via the pivot component to permit the brake portion topivot relative to the caster between a locked position in which thebrake portion engages with the caster wheel and an unlocked position inwhich the brake portion is disengaged with the caster wheel, theextension portion extending from the brake portion in a directionopposite the pivot component.
 2. The caster assembly of claim 1, whereinthe pivot component is pivotably coupled to the caster support.
 3. Thecaster assembly of claim 1, wherein the brake portion comprises a lockring.
 4. The caster assembly of claim 3, wherein the lock ring defines acircular opening.
 5. The caster assembly of claim 3, wherein the lockring defines an oval or egg shaped opening.
 6. The caster assembly ofclaim 1, further comprising a movable lock plate coupled to theextension portion of the lock member, wherein the movable lock plate istranslatable to pivot the brake portion between the locked position andthe unlocked position.
 7. The caster assembly of claim 6, furthercomprising a biasing member coupling the extension portion of the lockmember to the movable lock plate.
 8. The caster assembly of claim 6,further comprising a pedal coupled to the movable lock plate, whereinmovement of the pedal rotates the lock member between the lockedposition and the unlocked position.
 9. The caster assembly of claim 8,further comprising a latching mechanism configured to selectively retainthe pedal in a depressed position to retain the lock member in thelocked position.
 10. The caster assembly of claim 1, further comprisinga yoke coupled to the pivot component of the lock member, wherein theyoke is adjustable to offset a position of the pivot component relativeto the caster wheel.
 11. The caster assembly of claim 1, wherein thecaster is configured to swivel to a swiveled position relative to thesurgical console and the brake portion is configured to engage againstthe caster wheel in the swiveled position when the lock member is in thelocked position.
 12. A caster assembly for use with a surgical console,the caster assembly comprising: a plurality of caster wheels; aplurality of lock members corresponding to the plurality of casterwheels, each lock member comprising a pivot component, an extensionportion, and a brake portion coupled to the pivot component and theextension portion, the brake portion being pivotably mounted via thepivot component to permit the brake portion to pivot relative to arespective caster wheel, the extension portion extending from the brakeportion in a direction opposite the pivot component; and a movable lockplate coupled to the extension portion of each of the plurality of lockmembers, wherein the movable lock plate is translatable to pivot thebrake portion of each of the plurality of lock members about therespective pivot component between a locked position in which arespective brake portion engages with the respective caster wheel and anunlocked position in which the respective brake portion is disengagedwith the respective caster wheel.
 13. The caster assembly of claim 12,further comprising a biasing member coupling the extension portion of atleast one of the plurality of lock members to the movable lock plate.14. The caster assembly of claim 12, further comprising a pedal coupledto the movable lock plate, wherein movement of the pedal pivots thebrake portion of the plurality of lock members between the lockedposition and the unlocked position.
 15. The caster assembly of claim 14,further comprising a latching mechanism configured to selectively retainthe pedal in a depressed position to retain the brake portion of theplurality of lock members in the locked position.
 16. A caster assemblyfor use with a surgical console, the caster assembly comprising: acaster comprising: a caster support coupled to the surgical console; awheel support rotatably coupled to the caster support, wherein the wheelsupport selectively swivels relative to the caster support; a directionlocking mechanism comprising a keyway, wherein the keyway is rotatablebetween a direction locked position coupling the caster support and thewheel support together to prevent swivel of the wheel support relativeto the caster support and a direction unlocked position spacing apartthe caster support and the wheel support to permit swivel of the wheelsupport relative to the caster support; and a caster wheel rotatablycoupled to the wheel support; a key extending between a first end and asecond end, wherein the first end extends through the keyway of thedirection locking mechanism of the caster; a linkage coupled to the key,wherein the linkage is spaced apart from the keyway; and a pedalrotatably coupled to the linkage about a linkage pivot component,wherein the pedal is movable to rotate the linkage about the linkagepivot to rotate the key (i) to rotate the keyway toward the directionlocked position, and (ii) to rotate the keyway toward the directionunlocked position.
 17. The caster assembly of claim 16, furthercomprising: a lock member comprising a pivot component, an extensionportion, and a brake portion coupled to the pivot component and theextension portion, the brake portion being pivotably mounted via thepivot component to permit the brake portion to pivot relative to thecaster between a locked position in which the brake portion engages withthe caster wheel and an unlocked position in which the brake portion isdisengaged with the caster wheel, the extension portion extending fromthe brake portion in a direction opposite the pivot component.
 18. Thecaster assembly of claim 17, further comprising a second pedal coupledto the lock member, wherein movement of the second pedal pivots thebrake portion between the locked position and the unlocked position. 19.The caster assembly of claim 16, further comprising: a second caster,comprising: a second caster support coupled to the surgical console; asecond wheel support rotatably coupled to the second caster support,wherein the second wheel support selectively swivels relative to thesecond caster support; a second direction locking mechanism comprising asecond keyway, wherein the second keyway is rotatable between thedirection locked position preventing swivel of the second wheel supportrelative to the second caster support, and the direction unlockedposition permitting swivel of the second wheel support relative to thesecond caster support; and a second caster wheel rotatably coupled tothe second wheel support, wherein the second end of the key extendsthrough the second keyway of the second direction locking mechanism ofthe second caster.
 20. The caster assembly of claim 19, furthercomprising: a first and second lock member corresponding to the casterwheel and the second caster wheel, each lock member comprising a pivotcomponent, an extension portion, and a brake portion coupled to thepivot component and the extension portion, the brake portion beingpivotably mounted via the pivot component to permit the brake portion topivot relative to the caster, the extension portion extending from thebrake portion in a direction opposite the pivot component; and a movablelock plate coupled to the extension portion of each of the first andsecond lock members, wherein the movable lock plate is translatable topivot the brake portion of the first and second lock members about therespective pivot component between a locked position in which arespective brake portion engages with a respective caster wheel and anunlocked position in which the respective brake portion is disengagedwith the respective caster wheel.
 21. The caster assembly of claim 16,wherein the key comprises a shaft with a hexagonal cross-sectionalprofile.
 22. The caster assembly of claim 16, wherein the pedal definesan elongate slot to permit the linkage pivot to translate relative tothe pedal.
 23. A caster assembly for use with a surgical console, thecaster assembly comprising: a first and second caster, each castercomprising: a caster support coupled to the surgical console; a wheelsupport rotatably coupled to the caster support, wherein the wheelsupport selectively swivels relative to the caster support; a directionlocking mechanism comprising a keyway, wherein the keyway is rotatablebetween a direction locked position coupling the caster support and thewheel support together to prevent swivel of the wheel support relativeto the caster support and a direction unlocked position spacing apartthe caster support and the wheel support to permit swivel of the wheelsupport relative to the caster support; and a caster wheel rotatablycoupled to the wheel support; a key extending between a first end and asecond end, wherein the first end extends through the keyway of thedirection locking mechanism of the first caster and the second endextends through the keyway of the direction locking mechanism of thesecond caster; a first pedal rotatably coupled to the key, wherein thefirst pedal is movable to rotate the key (i) to rotate the keyway towardthe direction locked position, and (ii) to rotate the keyway toward thedirection unlocked position; a first and second lock membercorresponding to the caster wheel of the first and second caster, eachlock member comprising a pivot component, an extension portion, and abrake portion coupled to the pivot component and the extension portion,the brake portion being pivotably mounted via the pivot component topermit the brake portion to pivot relative to the caster, the extensionportion extending from the brake portion in a direction opposite thepivot component; and a second pedal coupled to the extension portion ofthe first and second lock member, wherein movement of the second pedalpivots the brake portion of the first and second lock members about therespective pivot component between a locked position in which arespective brake portion engages with a respective caster wheel and anunlocked position in which the respective brake portion is disengagedwith the respective caster wheel.